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Tuesday, November 17, 2009

From the time we're old enough to understand the word "alcoholic," we learn about the evils of alcohol. They're myriad: addiction, drunk driving, cirrhosis of the liver, high blood pressure, alcohol poisoning, kidney disease and so on. The strange thing is not that there are endless ways to die from a beverage. The strange thing is that this deadly beverage might actually be good for you under certain circumstances.

Alcohol has for decades been considered bad for your heart. It's linked to high blood pressure, obesity, diabetes and heart attacks, for a start; and people with heart disease, especially heart disease associated with high blood pressure, are almost always counseled to abstain completely. Recent evidence, though, suggests that people with heart disease might benefit considerably from drinking particular types of alcohol in particular dosages.

So where might alcohol fit in with reducing the risks associated with heart disease?

It's a snug fit, for sure, but research implies it's definitely there. The results have to do with a condition called atherosclerosis. Atherosclerosis is also known as clogging or narrowing of the arteries, and it's the primary cause of heart attacks. Cholesterol is a major contributing factor in atherosclerosis.

Cholesterol is a sticky, fatty substance, and when there's too much in the blood, it gets stuck to the artery walls. This ends up turning into a sticky plaque. Particles in the blood called platelets in turn get stuck to this plaque. Platelets cause your blood to clot so you don't bleed to death whenever to cut yourself. But this clotting ability can be deadly when it happens in the heart. Blood clots in arteries restrict blood flow, so oxygen-rich blood can't get to the heart. That's when a heart attack happens.

In a strange twist to conventional wisdom, it seems alcohol might decrease the chances of developing atherosclerosis and having a heart attack. It seems to have something to do with cholesterol.

In this article, we'll find out how alcohol might be beneficial to the heart, explore the particular circumstances that could lead to this benefit and find out what the heart experts have to say about it.

First, some quick background: There are two types of cholesterol that affect your heart, LDL and HDL. High levels of LDL cholesterol ("bad" cholesterol) and low levels of HDL cholesterol ("good" cholesterol) can lead to plaque buildup in the heart's arteries. High levels of HDL cholesterol, on the other hand, can prevent this plaque buildup. That's where alcohol comes in.

Does Alcohol Have a Plus Side?

It seems that having a couple of beers after work can raise your level of HDL cholesterol -- that's the good stuff -- and possibly prevent clotting, too. No one's exactly sure why this might be, but a study published in the journal "Circulation" set forth a possible reason why HDL levels might be boosted: Ethanol might increase the speed at which HDL proteins can travel through the blood.

Whatever the reason for the positive effects on the heart, those effects seem to be legitimate. One of the most recent studies to find heart-healthy results from drinking was published in January 2008.

Danish medical researchers tracked 12,000 men and women for two decades to see how alcohol and exercise affected their hearts. The first finding was to be expected: In both men and women, regular exercise decreased the risk of heart disease by about 32 percent. The surprise came when they looked at the effects of alcohol.

People who were active and did not drink alcohol at all had the 30 percent drop in heart disease. People who were active and consumed at least one alcoholic beverage a week had 50 percent fewer occurrences of heart disease than the people who exercised and drank no alcohol.

The benefit also applied to people who didn't exercise: Nonactive people who drank were 30 percent less likely to develop heart disease than the nonactive people who didn't drink. Of course, exercise alone also decreased the risk of heart disease, but exercise and drinking some alcohol produced the lowest heart-disease numbers overall.

Don't go out and get drunk just yet. The "some" distinction is a crucial one. The people in the Danish study who had a 50-percent decreased chance of heart disease were drinking one alcoholic beverage per week .The importance of moderation is backed up in every study on this topic. A 2007 U.S. study focusing on men found that those who drank one to two drinks a day had fewer heart attacks than those who drank less and those who drank more.In 2001, a University of Buffalo team looked at the drinking habits of women who already had heart disease and found that those who had one drink per day were less likely to have heart attacks than those who drank nothing In that study, wine was found to be more heart-healthy than liquor. The University of Buffalo scientists point out in their results that alcohol consumption increases a woman's chances of developing breast cancer.

That's the problem with the healthy alcohol concept: It's just not. Whatever benefits might be achieved by drinking between one and 14 alcoholic beverage per week, they're outweighed by the downsides of alcoholism, cancer, liver disease, obesity and, yes, heart disease. While alcohol might reduce clogging of the arteries under certain circumstances, it almost always raises blood pressure, causes weight gain and boosts triglyceride levels in the blood, all risk factors for heart disease. Triglycerides are fatty substances than can build up in the liver if the body doesn't break them down properly, and even small amounts of alcohol inhibit the body's processing of triglycerides.

The American Heart Association does not recognize alcohol intake as a legitimate heart-healthy activity. It advises against it, not only because alcohol is inherently unhealthy (it's a poison, after all), but also because the AHA doesn't believe the studies have proved that moderate alcohol consumption -- and not the drinkers' lifestyles -- leads to healthier hearts.

Even those scientists who published the studies do not recommend that any nondrinker start drinking to avoid heart disease. What to do, then? The same old boring, heart-healthy things: eating a low-fat diet, reducing salt intake and getting out for some exercise every day.

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